Substance abuse diagnoses increasing in U.S.

Possibly driven by a surge in painkiller abuse, the number of drug and alcohol problems diagnosed by U.S. doctors increased by 70 percent between 2001 and 2009, according to new research.

“We know that increases in prescription drug use are a big part of what’s going on nationally. I also think - in our study - the availability of effective treatment is a big part of it as well and likely drawing people into care,” said the study’s lead author Dr. Joseph W. Frank, from Brigham and Women’s Hospital in Boston.

Those treatments include medications such as methadone, as well as talk therapy.

The new study, which used information from two national surveys of doctors’ visits, estimated that the number of those visits involving drug or alcohol abuse or addiction increased from 10.6 million between 2001 and 2003 to 18 million between 2007 and 2009.

Over the same span, the number of visits including a diagnosis of opioid painkiller abuse, in particular, increased from 772,000 to 4.4 million - almost a six-fold increase.

Psychiatry researcher Amy Bohnert from the University of Michigan Medical School in Ann Arbor said she’s not surprised with the increase in opioid-related visits.

“It is quite a large increase and it does really highlight that this is a substantial problem in terms of this being a growing trend,” Bohnert, who wasn’t involved in the new research, told Reuters Health.

INTERNATIONAL STATISTICS

Among those using illicit drugs for the first time in 2007, the most popular substances were marijuana and prescription painkillers - each used by roughly the same number of Americans aged 12 and older. Non-medical use of painkillers rose 12%.

One in ten high school seniors in the US admits to abusing prescription painkillers.

Misuse of painkillers represents three-fourths of the overall problem of prescription drug abuse. The painkiller hydrocodone is the most commonly diverted and abused controlled pharmaceutical in the US.

Methadone, once used in addiction treatment centers and now used by doctors as a painkiller, was found as the cause of 785 deaths in one state alone, Florida, in 2007.

Prescription drug abuse is also climbing in older Americans, particularly involving anti-anxiety drugs such as Xanax and painkillers such as OxyContin.

In the UK, tens of thousands of people are said to be dependent on painkillers such as Solpadeine and Neurofen Plus.

Doctors and rehabilitation therapists report that prescription painkiller abuse is one of the most difficult addictions to treat.

“This finding is consistent with trends in substance use disorder-related utilization at the nation’s community health centers and emergency departments and, sadly, use of its morgues,” the study’s authors wrote in the Archives of Internal Medicine on Monday.

The Centers for Disease Control and Prevention estimate that 14,800 Americans died of an opioid overdose in 2008 - three times the number of overdose deaths 20 years earlier.

Across the U.S., it’s estimated that 22.5 million people are dependent on alcohol or drugs, according to Frank’s team.

Every day in the US, 2,500 youth (12 to 17) abuse a prescription pain reliever for the first time.

Prescription drug abuse, while most prevalent in the US, is a problem in many areas around the world including Europe, Southern Africa and South Asia. In the US alone, more than 15 million people abuse prescription drugs, more than the combined number who reported abusing cocaine, hallucinogens, inhalants and heroin.

In 2006 in the United States, 2.6 million people abused prescription drugs for the first time.

A 2007 survey in the US found that 3.3% of 12- to 17-year-olds and 6% of 17- to 25-year-olds had abused prescription drugs in the past month.

Prescription drug abuse causes the largest percentage of deaths from drug overdosing. Of the 22,400 drug overdose deaths in the US in 2005, opioid painkillers were the most commonly found drug, accounting for 38.2% of these deaths.

In 2005, 4.4 million teenagers (aged 12 to 17) in the US admitted to taking prescription painkillers, and 2.3 million took a prescription stimulant such as Ritalin. 2.2 million abused over-the-counter drugs such as cough syrup. The average age for first-time users is now 13 to 14.

Depressants, opioids and antidepressants are responsible for more overdose deaths (45%) than cocaine, heroin, methamphetamine and amphetamines (39%) combined. In the United States, the most deaths used to take place in inner cities in African-American neighborhoods, but they have now been overtaken by white rural communities. The same trend can be seen in the rates of hospitalization for substance abuse and emergency hospitalization for overdoses. Of the 1.4 million drug-related emergency room admissions in 2005, 598,542 were associated with abuse of pharmaceuticals alone or with other drugs.

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